Cross-classification of physical and affective symptom clusters and 180-day event-free survival in moderate to advanced heart failure.
Heart & lung : the journal of critical care
BACKGROUND: The relationship between physical and affective symptom clusters in heart failure (HF) is unclear.
OBJECTIVES: To identify associations between physical and affective symptom clusters in HF and to quantify outcomes and determinants of symptom subgroups.
METHODS: This was a secondary analysis of data from two cohort studies among adults with HF. Physical and affective symptom clusters were compared using cross-classification modeling. Cox proportional hazards modeling and multinomial logistic regression were used to identify outcomes and determinants of symptom subgroups, respectively.
RESULTS: In this young, mostly male sample (n = 274), physical and affective symptom clusters were cross-classified in a model with acceptable fit. Three symptom subgroups were identified: congruent-mild (69.3%), incongruent (13.9%), and congruent-severe (16.8%). Compared to the congruent-mild symptom group, the incongruent symptom group had significantly worse 180-day event-free survival.
CONCLUSION: Congruence between physical and affective symptom clusters should be considered when identifying patients at higher risk for poor outcomes.
Denfeld, Quin E; Bidwell, Julie T; Gelow, Jill M; Mudd, James O; Chien, Christopher V; Hiatt, Shirin O; and Lee, Christopher S, "Cross-classification of physical and affective symptom clusters and 180-day event-free survival in moderate to advanced heart failure." (2019). Articles, Abstracts, and Reports. 2521.